PARACETAMOL

I: Ma’am Valencia Generic Name Dosage
500 mg Paracetamol Form: IV

Mechanism of Action
Pharmacology: Paracetamol produ ces analgesia by raising the threshold of the pain center in the brain and by obstructing impulses at the pain-mediating chemoreceptors. The drug produces antipyresis by an action on the hypothalamus; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. Pharmacokinetics: Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. Following oral administration, peak plasma levels are attained in 10 min to 1 hr and the half-life is 75 min to 3 hrs. Distribution of paracetamol to most body tissues and fluids is both rapid and uniform. Paracetamol is excreted in the urine primarily as the glucuronide and smaller amounts as the sulfate, mercapturate and unchanged drug. Approximately 85% of a dose of paracetamol is excreted in the urine within 24 hrs after administration.

Indications
• Pyrexia of unknown origin. Fever & pain associated w/ common childhood disorders, tonsillitis, upper resp tract infections postimmunization reactions, after tonsillectomy & other conditions. Prevention of febrile convulsion.Headach e, cold, sinusitis, muscl e pain, arthritis & toot hache.

Adverse Reaction
• A paracetamol overdose is particularly dangerous because the liver damage may not be obvious for four to six days after the drug has been taken. Even if someone who has taken a paracetamol overdose seems fine and doesn't have any symptoms, it's essential that they are taken to hospital urgently. An overdose of paracetamol can be fatal. • When taken at the recommended dose, side-effects of paracetamol are rare. Skin rashes, blood disorders and a swollen pancreas have occasionally happened in people taking the drug on a regular basis for a long time.

Nursing Considerations
• Use liquid form for children and patients who have difficulty swallowing. • In children, don’t exceed five doses in 24 hours. • Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5 days or adults for longer than 10 days. • Advise patient or caregiver that many over the counter products contain acetaminophen; be aware of this when calculating total dailydose. • Warn patient that high doses or unsupervised long term use can cause liver damage.

Classification:
• Analgecsic (Opioid)

METOCLOPRAMIDE

Generic Name
10mg Metoclopramide Form: IV TAB

Dosage

Mechanism of Action
Pharmacology: Metoclopramide, a dopamine antagonist, stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary or pancreatic secretions. Its mode of action is unclear. It seems to sensitize tissues to the action of acetylcholine. The effect of metoclopramide on motility is not dependent on intact vagal innervation but it can be abolished by anticholinergic drugs. Metoclopramide increases the tone and amplitude of gastric (especially antral) contractions, relaxes the pyloric sphincter and the duodenum and jejunum, resulting in accelerated gastric emptying and intestinal transit. It increases the resting tone of the lower esophageal sphincter. Pharmacokinetics: Peak plasma levels are reached 30-60 min following an oral dose. Excretion is primarily in the urine. The plasma half-life is about 3 hrs. Metoclopramide undergoes minimal hepatic metabolism, except for simple conjugation. Its safe use has been described in patients with advanced liver disease whose renal function was normal.

Indications
• Disturbances of GI motility including GERD & diabetic gastroparesis. Naus ea &vomiting of central & peripheral origin associated w/ surgery, metabolic diseases, infectious diseases, migraine h eadache or drugs including cancer chemotherapy. Facilitate small bowel intubation & radiological procedures of GIT.

Adverse Reaction
• Restlessness, drowsiness, fatigue & lassitude. Extrapyramidal symptoms, insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia, rash including urticaria, bowel disturbances. Increased prolactin levels; gastroparesis.

Nursing Considerations
• Give 30 mins before meals and at bed time • Assess mental status during treatment • Tell patient to avoid driving & other hazardous activities for at least 2 hrs • Advice pt. to avoid alcohol and other CNS depressant that enhance sedating properties of this drug

Classification:
• GIT Regulators, Antiflatulents, Antiinfammatories

delirium.BDIAZEPAM Generic Name Diazepam Dosage Adult: 250-500mg every 8 hours Children: 2040mg/kg/day divided dosage given every 8 hrs Mechanism of Action Pharmacology:It increases neuronal membrane permeability to chloride ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilization. edema Dependence: Drug dependence with withdrawal syndrome Dermatologic: Urticaria. diaphoresis. burning. muscular disturbances. to avoid driving and activities that require alertness because drug can cause drowsiness  Inform pt. lethargy. dysarthria. CV collapse. stupor. redness after IM injection Nursing Considerations  Inform pt. hiccups. diarrhea. paresthesias. dermatitis GI: Constipation. tremor. difficulty in swallowing. sedation. peak plasma concentrations after 30-90 min (oral). hepatic impairment GU: Incontinence. fever. dry mouth. skin rash. that drug may be taken with food  Advice pt. pain. Pharmacokinetics: A: Readily and completely absorbed from the GI tract. disorientation. gynecomastia. vomiting. tachycardia. extrapyramidal symptoms. that smoking may decrease effect Classification: Benzodiazepine Therapeutic Class Antiepileptic. salivation. thrombosis. fatigue. confusion. anorexia. blood dyscrasias Other: Phlebitis. D: Readily crosses the blood-brain barrier. converted to desmethyldiazepam. depression. peak plasma concentrations after 10-30 min (rectal). Anxiolytic. slurred speech. mild drowsiness initially. menstrual irregularities Hematologic: Decreased Hct. elevation in blood enzymes. pruritus. nausea. Rapidly absorbed. redistributed into fat depots and tissues. apathy. changes in libido. Skeletal muscle relaxant . oxazepam and temazepam. Proteinbinding: 98-99%. not to abruptly discontinue drug after long term use  Advice pt. rigidity. hypertension and hypotension. E: Urine (as free or conjugated metabolites) Drug Half Life 20-80 hr Indications  Short-term management of anxiety Insomnia associated with anxiety  Sleepwalking  Night terrors  Premedication before anaesthesia  Adjunct in the management of seizures  Muscle spasms  Acute symptoms of alcohol withdrawal Adverse Reaction CNS: Transient. M: Extensively hepatic. mild paradoxical excitatory reactions. restlessness. urinary retention. headache. visual and auditory disturbances CV: Bradycardia.

peripheral vascular insufficiency. hypotension Dermatologic: Rash. conjunctivitis. Indications  Hypertension. blurred vision Nursing Considerations  Do not stop taking this drug unless instructed to do so by a health care provider. pulmonary edema. disorientation. sore throat. decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart. fatigue.  Swallow the ER tablets whole. crush. erythematous rash. sweating. dry eyes.METOPROLOL Generic Name Metoprolol 50mg Form: TAB Dosage Mechanism of Action Pharmacology: Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatus. or chew them. alone or with other drugs. acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone. dry skin EENT: Eye irritation. cardiac arrhythmias. Classification: Beta1-selective adrenergic blocker Antihypertensive . fever. laryngospasm CNS: Dizziness. emotional depression. decreasing cardiac output and the release of renin. tinnitus. claudication. memory loss. sleep disturbances. vertigo. slurred speech CV: CHF. hallucinations. paresthesias. pruritus. and lowering BP. do not cut. especially diuretics  Immediaterelease tablets and injection: Prevention of reinfarction in MI patients who are hemodynamically stable or within 3– 10 days of the acute MI  Treatment of angina pectoris Adverse Reaction Allergic: Pharyngitis.

epilepticus) Adverse Reaction Bradycardia. making it suitable for long-term use as an antiepileptic. depress motor output. impaired judgment. anesthesia. depress the cerebral cortex. lethargy. syncope. sedation. extravasation (IV use). rash. hypotension. • Monitor injection sites carefully for irritation. • Monitor P. barbiturates inhibit impulse conduction in the ascending RAS. thrombocytopenia. and deep coma. dizziness. apnoea (especially with rapid IV admin) Nursing Considerations  Administer IV doses slowly. nervousness.PHENOBARBITAL Generic Name Phenobarbital 60mg Form: TAB Dosage Mechanism of Action Pharmacology: General CNS depressant. anxiety. Indications  Treatment of generalized tonicclonic and cortical focal seizures  Emergency control of acute seizures (tetanus. megaloblastic anaemia. vastus lateralis) or other areas where there is little risk of encountering a nerve trunk or major artery. insomnia. respiratory depression. hallucinations. has antiseizure activity. headache. BP. confusion. drowsiness. nightmares. Classification: Barbiturate (long acting) Sedative Hypnotic Antiepileptic . eclampsia. CNS excitation or depression. alter cerebellar function.  Administer IM doses deep in a large muscle mass (gluteus maximus. and can produce excitation. respiration carefully during IV administration. Solutions are alkaline and very irritating to the tissues. at subhypnotic doses. hypnosis.

lacrimation (topical form). nausea. urinary frequency. Clostidium difficile. parenteral. pancreatitis. metallic taste. dizziness. 500mg tablets. peripheral neuropathy. candidal cervicitis or vaginitis. light-headedness. Fusobacterium. stinging sensation. anorexia. rash. burning or irritation of sexual partener’s penis. which inhibits bacterial nucleic acid synthesis and causes cell death. vomiting GU: Darkened urine. dry skin (topical form). fever. tell prescriber and stop drug immediately. Peptostreptococc us. After metronidazole is reduced. pharyngitis GI: Abdominal cramps or pain. don’t give by direct IN injection Classification: Antibiotic Amebicide Antiprotozoal .  To treat amebiasis (Entamoeba histolytica) Adverse Reaction CNS: Ataxia. encephalopathy.  Monitor CBC and culture and sensitivity test if therapy lasts longer than 10 days or if second course of treatment is needed  Give IV drug by slow infusion over 1 hr. tenderness. erythema. Peptococcus. pruritus. it damages DNA’s helical structure and breaks its strands. 750mg extended release tablet Mechanism of Action Pharmacology: Undergoes intracellular chemical reduction during anaerobic metabolism. and Veillonella sp. headache. vulvitis (vaginal form) HEME: Leukopenia MS: Back pain SKIN: burning sensation. and topical forms). diarrhea. Clostridium perfingens. Eubacterium.  Monitor pt with severe liver disease because slowed metronidazole metabolism may cause drug to accumulate in the body and increase the risk of adverse effects. as ordered. dysuria.  If skin irritation occurs. apply topical gel less frequently or discontinue it. Indications  To treat systemic anaerobic infections caused by Bacteroides fragilis. Nursing Considerations  If pt has adverse CNS reactions. such as seizures or peripheral neuropathy. urticaria (oral and parenteral forms) OTHER: injection site edema. seizures (high doses) EENT: Dry mouth.METRONIDAZOLE Generic Name Metronidazole Dosage IV: 500mg/100ml solution PO: 250mg. or. pain. vaginal candidiasis (oral.

urticaria. skin and soft tissue infections. before therapy is initiated. decreased creatinine clearance. Urogenital: Increased serum creatinine and BUN. gonorrhea. 7. . urinary tract infections.  Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated.. Monitor periodically BUN and creatinine clearance. penicillins. reducing or eliminating infection. and history of allergies.  Monitor for manifestations of hypersensitivity . lower respiratory tract infections.5g. 500mg Powder for injection: 750mg.  Monitor I&O rates . Skin: Ra sh . meningitis. causing cell death Therapeutic Effects: Bactericidal action Indications Treatment of It is effective for the treatment of penicillinaseproducingNeisseria gonorrhoea(PPNG).5g Premixed containers: 750 mg/50ml. 1. sinusitis.  Report onset of loose stools or diarrhea. Adverse Reaction GI: Diarrhea. bronchitis. otitis media.  Inspect IM and IV injection sites frequently for signs of phlebitis. pharyngitis/tonsilliti s. particularly to drugs. and is used for surgical prophylaxis. 250mg.CEFUROXIME Generic Name Cefuroxime Classification: Anti-infectives Dosage Tablets: 125mg. Therapy may be instituted pending test results.nausea.pruritus. Hemat: Hemolytic anemia MISC: Anaphylaxis Nursing Considerations  Determine history of hypersensitivity reactions to cephalosporins. antibiotic-associated colitis. Effectively treats bone and joint infections.5g/50ml Mechanism of Action Pharmacology: Bind to bacterial cell wall membrane. 1.

renal function studies. lethargies.  Culture infection. glossitis. paresthesias.  Monitor prothrombin time in patients w/ renal or hepatic impairment. vomiting.  Store at temperatures not exceeding 30°C. neutropenia (transient). eosinophilia Hepatic:hepatomegaly. mild skin and skin structure infections  Bone and joint infections Adverse Reaction CNS: Headache. Cephalosphorin (3rd Generation) Dosage 500 mg Powder for Injection Mechanism of Action Pharmacology:Interfere with a final step formation of the bacterial cell wall (inhibition of mucopeptide biosynthesis). resulting in unstable cell membranes that undergo lysis. Indications  UTI’s uncomplicated  UTI’s complicated  Uncomplicated pneumonia. and arrange sensitivity tests before and during therapy if expected response is not seen. fatigue. cell division and growth are inhibited. disulfiram-like reactions with alcohol Nursing Considerations  Assess for liver and renal dysfunction.  Discontinue if hypersensitivity occurs. administer these drugs separately. vertigo GI: nausea. leukocytosis. interstitial pnuemonitis. dizziness. diarrhea. malaise.  Have Vit.CEFTAZIDIME Generic Name Ceftazidime Classification: Antibiotic. reduce dose with dysfunction. abdominal cramps or pain GU: Nephrotoxicity Hematologic:leukopenia. sweating. hepatitis Other: Superinfections including oral candidiasis and enterococcal infections. hypotension. in a poor nutritional state or are on prolonged therapy. flushing dyspnea.  Obtain CBC. K available in case hypoprothrombinemia occurs. Also. More activity against gram-negative organisms and resistant organisms and les activity against gram-positive organisms than first-generation drugs.  Do not mix with aminoglycoside solutions. . lymphocytosis.

It also causes sedation and has some anticholinergic action. asthmatic attack. symptomatic prostatic hypertrophy.  Administer syrup form if patient is unable to take tablets. blurring of vision. GI disturbances. Indications  Relief of symptoms associated with perennial and seasonal allergic rhinitis. Antiparkinsonian. hallucinations. paradoxical stimulation in children. irregular heartbeat. tremors. bladder neck obstruction. narrow-angle glaucoma. loss of coordination.  Avoid alcohol.DIPHENHYDRAMINE Generic Name Diphenhydramine Hydrochloride 25 mg Form: Capsule Dosage Mechanism of Action Pharmacology: Diphenhydramine blocks histamine H1-receptors on effector cells of the GI tract. allergic conjunctivitis. third trimester of pregnancy.  Monitor patient response. blood dyscrasias Nursing Considerations  History: Allergy to any antihistamines. adjunctive therapy in anaphylactic reactions  Active and prophylactic treatment of motion sickness  Nighttime sleep aid  Parkinsonism Adverse Reaction CNS depression. thickened respiratory secretion. vasomotor rhinitis. pyloroduodenal obstruction. mild. headache. stenosing peptic ulcer. Classification: Antihistamine. visual disturbances. amelioration of allergic reactions to blood or plasma. lactation  Administer with food if GI upset occurs. dizziness. blood vessels and respiratory tract. dermatographism. dryness of mouth. uncomplicated urticaria and angioedema.  Report difficulty breathing. serious sedation could occur. unusual bleeding or bruising. Antimotion sickness drug. urinary retention. Sedative-hypnotic. sedation. Cough suppressant . and arrange for adjustment of dosage to lowest possible effective dose.

tonsils. Do not take 2 doses at once.  If you miss a dose of Tranexamic Acid. Antifibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots.  Swallow Tranexamic Acid whole with plenty of liquids.  For women who are taking Tranexamic acid to control heavy bleeding. or chew before swallowing. or are undergoing tooth extraction or other oral surgical procedures. uterus. in the leg. brain). or are at risk for blood clots  Current administration of factor IX complex concentrates or anti-inhibitor coagulant concentrates Nursing Considerations  Unusual change in bleeding pattern should be immediately reported to the physician. Adverse Reaction  Allergic reaction to the drug or hypersensitivity  Presence of blood clots (eg. antihemorrhagic 100 mg/ml Injection . The plasminogen-plasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen. thyroid.  Tranexamic Acid should be used with extreme caution in CHILDREN younger than 18 years old. take it when you remember. lungs. crush. lymph nodes and soft tissues.  Surgical: General surgical cases but most especially operative procedures on the prostate. safety and effectiveness in these children have not been confirmed. ovaries. By inhibiting the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis. have a history of blood clots. Do not break. then take your next dose at least 6 hours later. fibrin and other clotting factors. kidneys. lung. brain. eye.  The medication can be taken with or without meals. adrenals. the medication should only be taken during the menstrual period. heart. Classification: Anti-fibrinolytic. Indications  Treating heavy menstrual bleeding  Hemorrhage following dental and/or oral surgery in patients with hemophilia  Management of hemophilic patients (those having Factor VIII or Factor IX deficiency) who have oral mucosal bleeding. It exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules.TRANEXAMIC ACID Generic Name Tranexamic Acid Dosage Mechanism of Action Tranexamic acid is a synthetic derivative of the amino acid lysine.

. such as Alzheimer’s and Parkinsons. swelling in your face or hands. Special attention should be paid for administration in the neonate. premature and children. and cognitive disorders. Contact the physician immediately if allergic reaction such as hives. rash. Stay on the safe side and avoid use.  especially lecithin. Citicoline.CITICOLINE Generic Name Citicoline Dosage Mechanism of Action Citicoline seems to increase a brain  chemical called phosphatidylcholine. stroke. or itching. Citicoline might also decrease brain tissue damage  when the brain is injured. Not enough is known about the use of Citicoline during pregnancy and breastfeeding. It also is used by those who have age related mental decline. decreases following decline in brain activity with cerebral trauma. Indications Parkinson’s disease Head injury Cerebral vascular disease Alzheimer’s disease Cerebral surgery or acute cerebral disturbance Disturbance of consciousness following brain surgery Adverse Reaction  Body temperature elevation  Restlessness  Headaches  Nausea and vomiting  Diarrhea  Low or high blood pressure  Tachycardia  Sleeping troubles or insomnia  Blurred vision  Chest pains  Nursing Considerations  Citicoline may be taken Classification: Neurotonics. Women who are pregnant or trying to become pregnant should consult with their doctor before taking the supplements. The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping. Citicoline may be used for nutritional support in cerebral vascular disease. mouth or throat. Take it with or between meals.It is usually known that phospholipid. chest tightness or trouble breathing are experienced. accelerates  the biosynthesis of lecithin in the body. This brain chemical is important for brain  function. head trauma. which is a co-enzyme. Nootropics 500 mg Form: Capsule    with or without food. Citicoline is also believed to protect nerve cells when in low  oxygen conditions.

Assess for rhinitis. itching. nausea GU: oliguria. location. vasodilation GI: GI Bleeding. tinnitus. euphoria.  Advise patient to consult if rash.  Ketorolac therapy should always be given initially by the IM or IV route. or other OTC medications without consulting health care professional. Classification: Nonsteroidal Aanti-inflammatory agents. black stools. NSAIDs. renal toxicity. dizziness. dry mouth. abnormal taste. producing peripherally mediated analgesia Also has antipyretic and antiinflammatory properties. edema. or influenza-like syndromes occur. persistent headche.  Assess pain (note type. aspirin. acetaminophen.headache RESP: dyspnea CV: edema. Diarrhea. and nasal polyps are at increased risk for developing hypersensitivity reactions. and intensity) prior to and 1-2 hr following administration. GI pain. visual disturbances. Therapeutic effect:Decreased pain Indications Short term management of pain (not to exceed 5 days total for all routes combined)        Adverse Reaction CNS: drowsiness. Oral therapy should be used only as a continuation of parenteral therapy. aspirin-induced allergy. and urticaria.KETOROLOAC Generic Name Ketorolac Dosage 30mg/amp  Mechanism of Action Inhibits prostaglandin synthesis. weight gain. Nonopioid analagesics IM   . pallor.  Caution patient to avoid concurrent use of alcohol. dyspepsia. asthma. urinary frequency Nursing Considerations  Patients who have asthma.

20 mEq/15 mL liquid Mechanism of Action Replaces and maintains potassium level. Indications Hypokalemia Adverse Reaction  Nausea. arrhythmias. weakness or heaviness of limbs. 90 mEq vials. 40 mEq. 10 mEq. 500 mg. paresthesia of Nursing Considerations  Use cautiously in patients Classification: Electrolytes and Replacement solutions the extremities. give slowly as dilute solution. 25 mEq powder. possible cardiac arrest  Respiratory paralysis. 595 mg tablets. 25 mEq. hypotension. 50 mEq effervescent tablets. 15 mEq.  Make sure powders are completely dissolved before administering Know that drug is often used orally with potassiumwasting diuretics to maintain potassium levels. Never switch products without a doctor’s order. abdominal pain. heart block.   with cardiac disease and in those with renal impairment  Alert: IV use: Give by infusion only.POTASSIUM CHLORIDE Generic Name Potassium Chloride Dosage 6. potentially fatal hyperkalemia may result from too-rapid infusion  Give oral potassium supplements with extreme caution because different forms deliver varying amounts of potassium. 40 mEq/15 mL. 8 mEq. 20 mEq.  Post infusion phlebitis.7 mEq. 45 mEq/15 mL liquid. Never switch products without doctor’s order. . flaccid paralysis  ECG changes. 10 mEq. 2 mEq/mL injection. never give IV push or IM. Give oral potassium supplements with extreme caution because different forms deliver varying amounts of potassium. 20 mEq sustained release tablets. 60 mEq. 20 mEq/15 mL. 20 mEq.  Mental confusion. 20 mEq. vomiting. 30 mEq.

Metabolism: Hepatic. Specific COX-2 enzyme blocker 50 mg Form: Capsule     aware that patient may be at increased risk for CV events. Analgesic (nonopioid). GI bleeding. environmental control) and to reduce inflammation (eg. Administer drug with food or after meals if GI upset occurs.CELECOXIB Generic Name Celecoxib Dosage Mechanism of Action Therapeutic: Celecoxib has COX-2 specific inhibitory activity. kidneys and platelets catalyzed by COX-1. 11 hr (elimination half-life). positioning. It inhibits the conversion of arachidonic acid to prostaglandins while having no effect on the formation of prostaglandins that mediate the normal homeostasis in the GI tract. You may experience these side effects: Dizziness. Indications Hypokalemia Adverse Reaction  Acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis  Reduction of the number of colorectal polyps in familial adenomatous polyposis (FAP)  Management of acute pain  Treatment of primary dysmenorrhea  Relief of signs and symptoms of anklylosing spondylitis  Relief of signs and symptoms of juvenile rheumatoid arthritis Nursing Considerations  BLACK BOX WARNING: Be Classification: NSAID. Absorption: Absorbed from the GI tract (oral). Provide further comfort measures to reduce pain (eg. warmth. Excretion: Feces and urine (as metabolites and unchanged drug).  .Take drug with food or meals if GI upset occurs. monitor accordingly. induction of emesis. and rest). institute emergency procedures—gastric lavage. converted to inactive metabolites. peak plasma concentrations after 3 hr. positioning. WARNING: If overdose occurs. Distribution: Protein-binding: 97%. supportive therapy. drowsiness (avoid driving or the use of dangerous machinery while taking this drug).

 Monitor for S&S of doserelated peripheral or facial edema that may not be accompanied by weight gain. chronic stable angina and confirmed or suspected vasospastic angina. palpitations. severe edema may cause discontinuation of drug.  Monitor BP with postural changes. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. Report postural hypotension. Amlodipine is in a class of prescription called calcium channel blockers.  Report significant swelling of face or extremities. Monitor more frequently when additional antihypertensives or diuretics are added.  Report shortness of breath. BP reduction is greatest after peak levels of amlodipine are achieved 6–9 h following oral doses. rash GI: Nausea Abdominal discomfort Nursing Considerations  Monitor BP for therapeutic effectiveness.5 mg Form: Tablet    .AMLODIPINE Generic Name Amlodipine Dosage Mechanism of Action Inhibits calcium ions from entering the slow channels or select voltage sensitive areas of vascular smooth muscle and myocardium during depolarization.  Take care to have support when standing & walking due to possible doserelated lightheadedness/dizziness. doserelated palpitations (more common in women) may occur. Amlodipine is indicated alone or in combination with other prescription to treat high blood pressure and chest pain (angina). Indications Amlodipine is indicated for the treatment of hypertension. irregular heartbeat.  Monitor heart rate.  Adverse Reaction CNS: Dizziness Lightheadedness Fatigue Lethargy CV: Peripheral edema Arhythmias Dermatologic: Flushing. Classification: Cardiovascular agent Calcium channel blocker Antihypertensive agent 2. rarely.

an itchy skin eruption) Pruritus (Severe itching) Skin rashes Fever Arthralgia (sharp pain in a joint or joints) Edema (swelling from excessive accumulation of watery fluid)    Nursing Considerations Hypersensitivity to drugs Monitor for positive response to antibiotic therapy Monitor for signs of infections Classification: Cephalosporins 500 mg IV .                  Adverse Reaction Glossitis (inflammation or infection of the tongue) Heartburn Dizziness Tightness in the chest Headache Nausea Vomiting Diarrhoea Abdominal pain Vaginitis Candidal overgrowth (yeast-like infection) Urticaria (hives .CEFRADINE Generic Name Cefradine Dosage Mechanism of Action Inhibits mucopeptide synthesis in bacterial cell wall. Indications Reducing the numbers of postoperative infections in patients undergoing surgical procedures associated with a high risk of infection.

 Report any changes in urinary elimination such as pain or discomfort associated with urination. proteinuria. nausea. Indications Duodenal and gastric ulcer. and systemic mastocytosis.  Do not breast feed while taking this drug.  Report severe diarrhea. Classification: Gastrointestinal agent Proton pump inhibitor 10 mg. K+-ATPase enzyme system [the acid (proton H+) pump] in the parietal cells. abdominal pain. Longterm treatment of pathologic hypersecretory conditions such as Zollinger-Ellison syndrome. drug may need to be discontinued. Skin:Rash Nursing Considerations  Lab tests: Monitor urinalysis for hematuria and proteinuria. mild transient increases in liver function tests. multiple endocrine adenomas. fatigue. In combination with clarithromycin to treat duodenal ulcers associated with Helicobacter pylori. Gastroesophageal reflux disease including severe erosive esophagitis (4 to 8 wk treatment). 20 mg.OMEPRAZOLE Generic Name Omeprazole Dosage Mechanism of Action An antisecretory compound that is a gastric acid pump inhibitor.     Adverse Reaction CNS:Headache. 40 mg Capsules . Periodic liver function tests with prolonged use. Suppresses gastric acid secretion by inhibiting the H+. or blood in urine. Urogenital:Hematuria. dizziness. GI:Diarrhea.

urinary retention.CLONIDINE Generic Name Clonidine 75 mcg Dosage Mechanism of Action StimulatesCentral alphaadrenergicreceptors toinhibitsympatheticcardioaccelera torand vasoconstrictor centers. legs daily. hypopigmentation and hyperpigmentation of the skin Constipation Depression. Nursing Considerations  Assess bloodpressure andapical pulse beforeinitial dose. pruritus. If systolic bloodpressure is <90mmhg or pulse is<60 bpm. andioedema. allergic contact dermatitis.urticaria.actingdrugs Tablet . parotid pain.  Monitor input-output ratio: checkfor decreasingoutput. anxiety.      Adverse Reaction Local skin irritation. withhold drug andnotify physician.rash.  Check for edemain feet.  Note allergicreactions: fever. fatigue. sleep disturbances Impotence. anorexia. Nausea. Classification: Centrally. itching sensation of the eye. Indications Management of all grades of hypertension.

dyspepsia. lowers triglyceride levels. renal function tests  WARNING: Withhold atorvastatin in any acute. active hepatic disease. severe metabolic or endocrine disorder. Use extreme caution. abdominal pain. major surgery. liver evaluation. enhances reuptake and catabolism of LDL. serum LDLs (associated with increased risk of CAD). myalgia . and LDL cholesterol in patients with primary hypercholesterole mia (types IIa and IIb) and mixed dyslipidemia. trauma. arthralgia. serum triglycerides. lipid studies. heartburn. and 80 mg Dosage Mechanism of Action Inhibits HMG-CoA reductase. nausea. asthenia GI: Flatulence. pregnancy. constipation. acute serious illness.  History: Allergy to atorvastatin. hypotension. serious condition (severe infection. and homozygous familial hypercholesterole mia whose response to dietary restriction of saturated fat and cholesterol and other nonpharmacologic measures has not been adequate Adverse Reaction Nursing Considerations  Name confusion has been reported between written orders for Lipitor (atorvastatin) and Zyrtec (certirizine). 40.ATORVASTATIN Generic Name Atorvastatin 10. muscle strength. fungal byproducts. abdominal examination. lactation  Physical: Orientation. Classification: Antihyperlipidemic. Indications Adjunct to diet in treatment of elevated total cholesterol. 20. primary dysbetalipoprotein emia. increases hepatic LDL recapture sites. resulting in a decrease in serum cholesterol. liver failure Tablet   Respiratory: Sinusitis. seizures) that may suggest myopathy or serve as risk factor for development of renal failure. and increases serum HDLs (associated with decreased risk of CAD). affect. the enzyme that catalyzes the first step in the cholesterol synthesis pathway. cramps. pharyngitis Other: Rhabdomyolysis with acute renal failure. HMG-CoA reductase inhibitor   CNS: Headache. LFTs.

25 mg/mL IV Initial hypotension may be severe and prolonged. renal impairment or failure.ENELAPRIL Generic Name Enelapril 2. Potentially Fatal: Angioedema. especially thiazide-type diuretics  Treatment of acute and chronic CHF  Treatment of asymptomatic left ventricular dysfunction (LVD)  Unlabeled use: Diabetic nephropathy. rash.  Adverse Reaction Nursing Considerations  WARNING: Alert surgeon. Dizziness.  Be aware that use of this drug in second and third trimesters can cause serious injury or death to the fetus. 10. . Classification: Antihypertensive. fatigue. 5.5. headache. vomiting.  Monitor patients on diuretic therapy for excessive hypotension after the first few doses of enalapril. abnormal taste. persistent dry cough. hypotension may be reversed with volume expansion. Ventricular hypertrophy is reversed. advise contraceptive use. lassitude. ACE inhibitor Tablet 1. Dosage Mechanism of Action Enalapril is de-esterified into the active enalaprilat resulting in potent inhibition of ACE thus leading to reduced levels of angiotensin II and aldosterone. diarrhea) because excessive hypotension may occur. the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked. Indications  Treatment of hypertension alone or in combination with other antihypertensives. Clinically.  and mark patient's chart with notice that enalapril is being taken.  Monitor patient closely in any situation that may lead to a drop in BP secondary to reduced fluid volume (excessive perspiration and dehydration. BP is reduced. neutropenia. 20 mg. Renal blood flow is increased but in patients with renal impairment there may be oliguria or acute renal failure. salt and water retention is corrected.

with the following vital signs: T. verified doctor’s order. D> on full diet A> advised mother to feed her child nutritious foods such as fruits and vegetables and give it as much as she likes. R> patient was able to rest. due medications given. vital signs taken and recorded. kept safe and comfortable.38. RR20. needs properly attended. with materials.5 degrees. with foley catheter to urine bag draining yellow urine. prepared patient with OR attire. Obnamia’s order. PR. instructed patient on nothing per orem. A> tepid sponge bath done. D> 40 y/o male. Obnamia with verbal order of Paracetamol 500 mg.9. gave Paracetamol 500 mg as per Dr. encouraged deep breathing exercise.4. with OR proposal. with consent for procedure. instructed patient to wear loose clothing. incision and drainage day1 A> assessed patient. skin is flushed and warm to touch. BP. status post emergency wound debridement. advised also to give fresh fruit . on left hand infusing well. left foot dressing dry and intact. 10:00 AM F> Hyperthermia 11:00 AM F> For Emergency Wound Debridement 1:00 PM F> Post-operative Care 11:00 AM F> Health Teaching Regarding Diet D> increase in body temperature above normal range T. due meds given.36. vital signs taken and recorded. advised to remove underwear. conscious and coherent. patient’ temperature decreased to 37. with MRA A> assessed patient. Dr. R> still for emergency wound debridement.80. D> with diagnosis of non-healing wound 4th digit on left foot. with D5LR 1000 ml x 8 hrs. provided opportunity for patient to rest.120/80. informed resident on duty. instructed to drink plenty of fluids.FDAR 6:00 AM F> Post-endorsement Assessment D> awake on bed. dentures. nail polish and jewelries. on diet as tolerated. kept rested and comfortable.

9. D> fresh blood noted with the stool A> vital signs taken. kept well monitored. sharp pain on abdominal incision area. informed rehabilitation medicine c/o ma’am Lhisa for follow and to wait for the doctor’s rounds. medicated with Tramado l 50 mg IV as per Dr. coordinated with pharmacy for clearance. RR. Fausto’s order. states pain is 8/10. due meds given. informed intern on duty for discharge summary. all needs are attended. D> s/p excision of meningioma with orders by Dr. Realino.20. monitored vital signs and charted. informed Dr. advised relative to always stay at bedside. D> with discharge orders made by Dr. PR. Atazan. D> complaining of continuous.80. R> still for discharge. coordinated with social service ma’am Sharon regarding borrowed blood. R> mother understood the importance of health teaching. R> checked and examined by rehabilitation medicine Dr. Sheryl G. A> assessed. D> less movement with verbalization of “Di ako makatulog. advised to secure necessary requirements for discharge. vital signs taken and recorded as follows: T. A> assessed patient. BP. RN Nursing Service .120/80. advised patient and relative to inform nurse on duty once incident re-occur. provided comfort measures and provided opportunity to rest. Madali akong nagigising” A> assessed patient’s needs. Calma. verified doctor’s order. atazan A> verified and carried out doctor’s order. Ancheta.9:00 AM F> Referral to Rehabilitation Medicine 8:30 AM F> Hematochezia 10:00 AM F> Pain 10:00 AM F> Sleep Deprivation 1:30 PM F> To Discharge juices aside from water. morning care done. kept rested. R> reported pain is reduced from 8/10 to 3/10. informed patill for dient and relative. informed patient about her rehabilitation.36.

Realino.Sheryl G. RN Nursing Service .